Heme onc
Terms
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- mediates linking of subendothelial collagen and Gp1b
- vWF
- allows insertion of GpIIb/IIIa into membrane
- ADP binding
- inhibits epoxide reductase
- warfarin; prevents activation of vit K
- activates ATIII
- heparin
- inactivated by ATIII
- II, VII, IX, X, XI
- activated by IIa (thrombin)
- V, VIII, XIII
- required by vit K
- II, VII, IX, X, C, S
- activates Protein C
- Protein S, thrombomodulin (endothelial cells)
- cleaved by protein C
- Va, VIIIa
- inc risk of hemorrhagic skin necrosis following warfarin adm
- protein C or protein S defiency
- activates kallikrein
- factor XIIa
- kallikrein activates...
- plasmin and bradykinin plasmin activates C3 bradykinin causes vasoD, inc vascular permeability, pain
- tests all factors except VII and XIII
- PTT (intrinsic)
- tests extrinsic pathway (I, II, V, VII, X)
- PT
- inc bleeding time
- defects in plt plug formation -Glanzmann's thrombasthenia - dec GpIIb/IIIa -Bernard-Soulier dz - dec GpIb -vW's dz -DIC, thrombocytopenia - dec plts
- inc PTT
- -hemophilia A - VIII deficiency -hemophilia B - IX deficiency -vW's dz - nl or inc PTT -DIC - general consumption of coag factors -vit K deficiency - dec II, VII, IX, X
- inc PT
- DIC vit K deficiency
- sx of intravascular hemolysis; sx of extravascular hemolysis
- intravascular: hemoglobinuria extravascular: jaundice
- spherocytes
- -hereditary spherocytosis -AHA
- macro-ovalocytes
- -megaloblastic anemia (with hypersegmented PMNs) -marrow failure
- helmet cells, schistocytes
- DIC, TTP/HUS, traumatic hemolysis
- bite cells
- G6PD deficiency
- teardrop cells
- myelofibrosis
- acanthocytes (spur cells)
- -liver dz -abetalipoproteinemia
- target cells
- -HbC dz -asplenia -liver dz -thalassemia "HALT" said the hunter to his target.
- burr cells
- TTP/HUS
- basophilic stippling
- Thalassemias Anemia of chronic dz Iron deficiency Lead poisoning
- basophilic nuclear remnants found in RBCs; seen in pts with hyposplenia/asplenia
- Howell-Jolly bodies
- oxidation of Fe leads to denatured Hb ppt and damage to RBC membrane
- Heinz bodies seen in a-thalassemia, G6PD deficiency
- PDE inhibitors used to inhibit plt aggregation
- cilastozal, dipyridamole
- filgrastim
- G-CSF used for neutropenia
- GM-CSF
- secreted by macrophages, T cells, mast cells, endothelial cells and fibroblasts white blood cell growth factor